Contact dermatitis is one of the most common inflammatory dermatoses seen in the dermatologist’s office and includes allergic contact dermatitis (ACD), irritant contact dermatitis (ICD), photoallergic contact dermatitis, photoirritant contact dermatitis, and protein contact dermatitis.[1]Scheinman PL, Vocanson M, Thyssen JP, et al. Contact dermatitis. Nat Rev Dis Primers. 2021 May 27;7(1):38.
http://www.ncbi.nlm.nih.gov/pubmed/34045488?tool=bestpractice.com
In one meta-analysis of 28 studies and over 20,000 individuals, the worldwide prevalence of contact dermatitis in the general population is estimated to be 20.1%.[2]Alinaghi F, Bennike NH, Egeberg A, et al. Prevalence of contact allergy in the general population: a systematic review and meta-analysis. Contact Dermatitis. 2019 Feb;80(2):77-85.
http://www.ncbi.nlm.nih.gov/pubmed/30370565?tool=bestpractice.com
ICD accounts for up to 80% of contact dermatitis and ACD accounts for nearly 20%, with the remainder making up much smaller proportions.
Contact dermatitis is the most common occupational skin disease, with ICD being the most common variant. Certain industries are especially susceptible to occupational ICD including hairdressing, construction, food service, health care, and metallurgy.[3]Pesonen M, Jolanki R, Larese Filon F, et al. Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe: analyses of the European Surveillance System on Contact Allergy network, 2002-2010. Contact Dermatitis. 2015 Mar;72(3):154-63.
http://www.ncbi.nlm.nih.gov/pubmed/25639629?tool=bestpractice.com
Out of 1019 new diagnoses of occupational skin disease reported by dermatologists in the UK in 2019,876 (86%) of these were contact dermatitis.[4]Health and Safety Executive (UK). Work-related skin disease in Great Britain, 2022. November 2022 [internet publication].
https://www.hse.gov.uk/statistics/causdis/dermatitis/skin.pdf
According to the British Association of Dermatologists, between 4% and 7% of dermatological consultations in secondary care are for contact dermatitis.[5]Johnston GA, Exton LS, Mohd Mustapa MF, et al. British Association of Dermatologists' guidelines for the management of contact dermatitis 2017. Br J Dermatol. 2017 Feb;176(2):317-29.
https://academic.oup.com/bjd/article/176/2/317/6601881
http://www.ncbi.nlm.nih.gov/pubmed/28244094?tool=bestpractice.com
ACD affects an equal proportion of adults and children.[6]Silverberg JI, Hou A, Warshaw EM, et al. Age-related differences in patch testing results among children: analysis of North American Contact Dermatitis Group data, 2001-2018. J Am Acad Dermatol. 2022 Apr;86(4):818-26.
http://www.ncbi.nlm.nih.gov/pubmed/34314743?tool=bestpractice.com
ACD may affect up to 20% of children and it has been documented in patients as young as 6 months.[7]Belloni Fortina A, Cooper SM, Spiewak R, et al. Patch test results in children and adolescents across Europe: analysis of the ESSCA network 2002-2010. Pediatr Allergy Immunol. 2015 Aug;26(5):446-55.
http://www.ncbi.nlm.nih.gov/pubmed/25939691?tool=bestpractice.com
[8]Borok J, Matiz C, Goldenberg A, et al. Contact dermatitis in atopic dermatitis children: past, present, and future. Clin Rev Allergy Immunol. 2019 Feb;56(1):86-98.
http://www.ncbi.nlm.nih.gov/pubmed/30225535?tool=bestpractice.com
Children may be more susceptible to developing ICD, particularly those with an impaired skin barrier function such as in eczema.[9]Belsito DV. Occupational contact dermatitis: etiology, prevalence, and resultant impairment/disability. J Am Acad Dermatol. 2005 Aug;53(2):303-13.
http://www.ncbi.nlm.nih.gov/pubmed/16021126?tool=bestpractice.com
Adult women are affected slightly more than adult men overall but there have been no statistically significant sex differences noted in children.[2]Alinaghi F, Bennike NH, Egeberg A, et al. Prevalence of contact allergy in the general population: a systematic review and meta-analysis. Contact Dermatitis. 2019 Feb;80(2):77-85.
http://www.ncbi.nlm.nih.gov/pubmed/30370565?tool=bestpractice.com
[10]Diepgen TL, Ofenloch RF, Bruze M, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016 Feb;174(2):319-29.
http://www.ncbi.nlm.nih.gov/pubmed/26370659?tool=bestpractice.com
Sex differences may be attributed to social and environmental factors: for example, exposure to allergens such as jewellery may be more common in women than in men.
Few studies have examined racial differences in contact dermatitis. A study from the North American Contact Dermatitis Group (NACDG) from 1998-2006 showed similar prevalence of ACD and ICD among black and white people referred for patch testing.[11]Deleo VA, Alexis A, Warshaw EM, et al. The association of race/ethnicity and patch test results: North American Contact Dermatitis Group, 1998-2006. Dermatitis. 2016 Sep-Oct;27(5):288-92.
https://www.jaad.org/article/S0190-9622(21)02497-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/27649352?tool=bestpractice.com
A more recent study using data from 2007-2016 showed that the prevalence of positive patch reaction was similar between white, black, Latino, and Asian people referred for patch testing.[12]Foschi CM, Tam I, Schalock PC, et al. Patch testing results in skin of color: a retrospective review from the Massachusetts General Hospital contact dermatitis clinic. J Am Acad Dermatol. 2022 Aug;87(2):452-4.
https://www.jaad.org/article/S0190-9622(21)02497-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34547356?tool=bestpractice.com